Prophylactic surgery for lymphoedema: a new study extends prevention to other cancer settings

A recent scientific publication to which Dr Jaume Masià contributed describes how to incorporate protection of the lymphatic system into the surgical procedure itself for certain sarcomas of the lower limb. The study extends to other oncological settings a strategy that has been more extensively developed in the field of breast cancer: identifying, preserving and, where necessary, reconstructing the lymphatic pathways before lymphoedema develops.

Is it possible to take action against lymphoedema before it develops?

This question is becoming increasingly relevant in oncological surgery. Certain procedures required to treat cancer can disrupt the pathways through which lymph circulates and, months or even years later, lead to the onset of lymphoedema.

A paper published in March 2026 in *Plastic and Reconstructive Surgery – Global Open* addresses this issue from a perspective that has so far been less well studied: surgery for soft-tissue sarcomas of the lower limb.

The article, authored by Laura Torrano, Paúl Zamora-Alarcón, Jaume Masià and other specialists, describes, step by step, a strategy for prophylactic lymphoedema surgery integrated into tumour resection.

The approach does not involve treating lymphoedema once it has developed, but rather assessing the drainage pathways prior to surgery, preserving those that can be spared without compromising oncological surgery, and reconstructing those that must inevitably be interrupted.

For Dr Jaume Masià, head of Plastic and Reconstructive Surgery at the Publio Cordón Memorial Hospital, this approach to surgery reflects a significant shift in the development of lymphatic surgery.

‘The key change is not to think solely about how to treat lymphoedema once it has already developed. In certain patients, we can anticipate this and ask ourselves what we can do during the oncological surgery itself to preserve or reconstruct lymphatic drainage.’